OT: Stockton CA to file for bankruptcy, will be largest U.S. city to fail

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Robert Macy wrote:

I'm not calling you a liar, you dumb shit.
Read again what I said.
I pointed out if your story is true (and I'm not saying that it's not true) then the amount of fraud in the billing relationship between your insurance companies and hospitals in the US must be insane - and therefore no wonder your heathcare insurance and delivery systems are so screwed up.
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Words mean something, by saying "if your story is true" absolutely is calling mea liar, because you are NOT accepting my statement as factual event.
To answer 'falling for it" Again, the prices I paid were 1960 prices, not simply low prices for today, but back to the really really normal pricing.
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Robert Macy wrote:

You're just some anonymous shmuck on usenet.
If I'm going to make a statement based on your evidence, I have to premis my statement by not necessarily accepting your hospital billing experience as factual or even typical.
And while you're being anally-focused on that aspect of my post, you're completely missing the vastly more important point that I was making. Which I will state again and see if it provokes a response from you:
Your hospital billing experience indicates that the amount of fraud in the billing relationship between american insurance companies and hospitals must be insane, fraudulent or even criminal - and therefore no wonder your heathcare insurance and delivery systems are so screwed up.
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Home Guy wrote:

as are you, only difference is you're just a larger smuck
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If by "fraud" you mean the game played between healthcare providers and insurance companies. Every insurance/medicare paid bill I've seen includes some amount of "write-off". Providers use exaggerated list prices to keep upward pressure on the amount that IC determines is reasonable and customary.
m
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Fake ID wrote:

That doesn't make for an efficient system.

That's a primary failing of the US heath-care system.
It employs about 2 million more people than it should in the back offices of hospitals and insurance companies.
These are the people doing battle with each other on a daily basis over billing and payments.
And I agree with what you said about Robery Macy's "cash-customer" experience. He will likely get more bills in the mail and face creditor problems over his recent visit to the ER.
The ER is peculiar in the landscape of the US medical system. I understand you can't be denied emergency treatment if you show up at any ER department, and some (large?) component of the cost of running ER's is paid for by gov't.
So his experience of some administrator cutting him a huge deal because he paid in cash is most likely not typical of other forms of medical treatment and care (emergency vs elective). For example, if he was planning to undergo some form of elective surgery (cardiac bypass, cancer, etc) I doubt he would get very far in the preliminary work-up if he expected to pay a "1960's" era bill for it.
And again being that he was an ER patient, and they supposedly cut him a huge deal (orders of magnitude) this could be explained away as them treating him as a charity case.
But yea. Robert - you come back here in 6 months and tell us how your ER visit REALLY turned out from a cost point of view.
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Will do, as listed in response to other person.
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In wrote:

Cite some proof?
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wrote:

It's quite common and even has a name. It's called up/down coding.
Anyone that believe you can't cheat an honest man has never had to deal with an insurance company on a claim.
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Me too.

My experience with ERs suggests that you are not done paying. Yes, you paid the hospital and got a discount (me too). Now sit back and wait for the bill from the medical group that the MD belongs to. And something else...I forget what, except that I remember that 1 ER visit generated 3 bills (including the hospital, paid on the spot).
By way of a life without insurance story...where I went for an ultrasound an (don't remember which) paddle was attached to my paperwork that I carried around the facility once they found out I was self-pay.
m
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On 06/30/12 03:40 am, Fake ID wrote:

Many people have suggested that the insurance companies in fact pay *far less* than what John Doe gets charged -- but perhaps that's only if they have to bill John Doe. Hospital and medical-practice billing depts. are huge and expensive.

Could include bills for the lab., the X-Ray dept., the radiologist,...
Perce
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I worked for many years in the Business Ofc. at a large hospital. Medicare, Medicaid and Blue Cross all paid on a per diem basis. Both for inpatient and also for outpatient. There was a different per diem for the outpat. clinic and for the Emerg. Dept. I seem to recall there was also a perdiem for inpat. MV accidents, but it's so long ago don't recall exactly. I have no idea who made up this per diem stuff. We just had to carry out the billing to the insurances. Don't get me started on the Medicaid people who came to the Emerg. Dept for stupid shit, just because it was for "free".

There was the Hosp. on 1 bill and the radiologist on a 2nd bill. The Xrays themselves were included with the hosp. bill. We used to get tons of calls complaining. We couldn't control that, because it was the Radiologists that wanted to bill separately. We told the patients to call the Administrators and complain to them.

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t-email.me:

It was my understanding that the bill was 'total' else I would not have acquiesced.
All results occurred AT THE TIME. no delay to interpret, implying that again the bill was 'total'
Checking throu papers, I did not see any reference to potential follow on bills,
BUT, I will definitely come back and let people know either way.
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That's true if you are talking about the *same* people each time.
If everyone sends a separate bill (including the company that provides black pens to doctors to fill out forms, and the different company that provides red pens to doctors to fill out forms, and the janitorial services company that cleans up the operating room, and the different janitorial services company that cleans up your room after you leave, and the city water department that separately meters each hospital room, and each individual nurse), then it's not fraud. It's horribly inefficient, but it's not fraud.

I find it interesting that it would be actually worthwhile to have a health insurance policy with a trillion-dollar deductible. They will never pay anything. However, you get the insurance-company prices, which may end up being a third of the originally-billed amounts for lab tests and doctor visits, and you don't have to pay the difference.
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wrote:

No, they're in default when the loan repayment stops and it sounds like that has already happened. Certainly a bankruptcy court will decide what, if any, bills will be paid, but they're already in default.

Sure. That *has* to happen. The outgo has to come into line with the income.
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At least the weather will soon be nicer in North USA.
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